“Horses with lameness in more than one limb are a diagnostic challenge, especially if both a forelimb and a hindlimb are involved,” said Sue J. Dyson, FRCVS, of the Center for Equine Studies at the Animal Health Trust, during her presentation on the topic at the 43rd British Equine Veterinary Association Congress, held Sept. 15-18 in Birmingham, U.K. “The first key to successful diagnosis is determination of which are the lame limbs.

“This is particularly difficult if the horse moves with a short, shuffling gait rather than overt lameness,” she went on. “Very careful evaluation of the horse under a variety of circumstances, straight lines, circles on soft and hard surfaces, and if necessary ridden, and assessment of response to flexion tests, are crucial. The investigator should first evaluate the overall way the horse moves, focusing first on the forelimbs and then on the hindlimbs. Watch the horse carefully as it turns to change direction; discomfort while turning may reflect foot pain.”

She noted that practitioners should pay close attention to the rider’s hands when a horse is worked under saddle, as some riders can induce a head nod in a sound horse, making him appear lame. “You need a skilled rider to help you assess response to nerve blocks,” she said